News & Features

Nurses in the era of COVID-19

A Few Minutes With Tammy Seraphin-Nursing during COVID-19

Vince Lara in the communications office at the College of Applied Health Sciences speaks with Tammy Seraphin, Assistant Director of the MS Health Administration program at Illinois and a registered nurse, about the COVID-19 crisis.

Click here to see the full transcript.

VINCE LARA: Hi, and welcome to another edition of A Few Minutes With, the podcast that showcases Illinois' College of Applied Health Sciences. I'm Vince Lara, and today I'm speaking with Tammy Seraphin, a registered nurse and health care administrator who is also assistant director of our masters in health administration program to talk about the COVID-19 crisis.

All right, speaking with Tammy Seraphin, who is a registered nurse and has worked in health care administration. And so Tammy, you are uniquely qualified I think to talk about this health care crisis with COVID-19. And I wanted to ask you, what are people in each of those roles experiencing?

TAMMY SERAPHIN: Well, thanks for having me, Vince. One of the things I will mention is that nurses work in a variety of roles. Although most people probably think of nurses, you know, they're dressed in scrubs, they work in a hospital or a doctor's office taking care of patients, but there are many nurses that work behind the scenes in areas such as quality, in case management, infection prevention, and, of course, in leadership roles.

But regardless of what role the nurses are currently working in, we all understand that patients are at the center of everything that we do. We also alleged during our graduation ceremonies to, quote, "devote ourselves to the welfare of those committed to our care." And right now, nurses, especially those direct patient care nurses, are doing exactly what they pledged to do.

They're still taking care of the patients even in times of crisis. And that devotion and commitment is really to be honored and celebrated. And even those nurses who work in non-direct patient care jobs still play a role in supporting patient care. And, in fact, you'll even see some of those nurses returning to direct patient care temporarily to provide more support to the frontline staff.

In fact, I just received earlier this week a statewide alert asking for our licensed and even previously licensed professionals to sign up to help fight this pandemic. And when you look at leaders, leaders are being pulled in many directions during a time like this. And what's interesting is they have to consider that patients are not the only priority.

They have to think about the employees, too. Leaders need to be present and listening to the concerns of those frontline staff. They have to make decisions quickly but very thoughtfully as well. And being willing to collaborate with other organizations is key.

As we are seeing today, the partnership between our local hospitals, the public health departments, and other health agencies is evident, because the public needs accurate and consistent communication, and you can't have that without collaboration. And it's no doubt it's a stressful time for those involved in any health care role.

There have been and will continue to be long, exhausting days. And one of the things I've seen in the last few years is an uptick on the importance of caring for the caregiver. And a lot of times, we think of caregivers as those who are assisting, say, with an elderly parent or perhaps those caring for a child with special needs.

But in this case, though, I am referring to the caregivers in the professional sense. They're providing care in these stressful moments, and that can sure take a toll on their physical and emotional health. And it's important for our employees to feel like they've got the support, and the resources, and opportunities to take care of themselves and to help keep them from becoming another patient.

VINCE LARA: You know, I'm sure you have experience with similar epidemics. Tammy, H1N1 and the Ebola virus. How did you deal with that?

TAMMY SERAPHIN: Well, the most recent epidemic or outbreak that I dealt with was actually with measles last year. That was the one I was really heavily involved in. Things like Ebola, I helped to do some preparation for that. But really, the measles outbreak from last year is my most recent experience.

And I remember sitting at a high school basketball game on a Friday evening, and got a call, and said, we likely had our first case of measles. And by Saturday morning, I was put in charge of implementing operational changes for our clinic.

We had to change how our walk-in traffic was processed, how the patients were roomed, how we were going to staff, how we were going to keep communications with the students and staff. And then not to mention the numerous phone calls that we would get, of course, from concerned students, and parents, and community members.

Sometimes, they were just asking simple questions related to, say, the measles vaccine or their exposure risk. But there were certainly a lot of questions regarding quarantine orders because they, too, had 14-day quarantines for people who were potentially exposed at that point as well.

But I will say having been on the frontlines with that, I was absolutely amazed at how well organized the emergency response was throughout our community and in the clinic where I worked. And I can say all of that was based on communication.

And whether that was through the conference calls we did with our state and local public health leaders to the other health agencies locally and the messaging that we have for our students and staff, that messaging, again, had to be very clear and consistent. But that emergency response, like I said, it was absolutely amazing to me.

VINCE LARA: What's the most difficult issue to deal with in this type of situation, Tammy? Is it understaffing? Is it not enough beds, not enough Personal Protective Equipment, or not enough equipment in general? What, in your opinion?

TAMMY SERAPHIN: Sure. Since I'm not dealing with the COVID-19 pandemic directly on the front lines, it's kind of hard to say, and it's really going to differ from community to community. But one of the things I am concerned about is what I'm hearing regarding the Personal Protective Equipment, or PPE-- I'm sorry-- PPE situation.

One of the first clinical lessons I remember in nursing school was about handwashing and glove use. And so it's ingrained in us early on how important handwashing and using appropriate PPE is. And when we are taught that medical equipment that's labeled single use only is meant to be single use only, and not from patient to patient and things.

So I certainly don't like hearing about the situations when we can't be as safe as we should be when it comes to accessing and using PPE. And I guess one of the other concerns I have goes to the staff, and that's the burnout and potential illness that staff are facing. These are essential employees, and not able to work from home.

And so those that are working in settings that operate 24/7, 365, those facilities don't close, and you have to have staff there to care for patients. So that's one of the main things I feel like it's fairly difficult to manage that right now. But it's my hope that we can keep our medical, and nursing, and other ancillary staff physically and emotionally healthy so they can continue to take great care of the patients that are there now.

VINCE LARA: Yeah. You know, there's no way you can anticipate this, but what advice would you give someone who's entering the nursing field now? I mean, you have people who are graduating who are getting let off their final semester to enter the nursing field. So what advice do you have for them?

TAMMY SERAPHIN: Probably not so much specific to what's happening now. That's a great question. And I guess I would have maybe three things to mention. The first one I'm going to say is to just stay with it. It's not uncommon for nurses to experience burnout early on or even a few years in.

In fact, I just recently reviewed a study from 2019 that showed about 25% to 30% of nurses actually leave their roles within the first couple of years, and that's a scary number to me. We have to focus on reducing that percentage. And we've got a large number of nurses retiring, and we're not getting enough new nurses out there to replace them.

So if I've got someone who's thinking about getting out of the profession, I would just simply remind them that he or she was drawn to nursing for a specific reason. And if you don't really like the position that you're currently in, there are so many other opportunities to put your knowledge and skills to use. Really, don't give up on the nursing profession. We can just try something different.

So I guess the second piece of this is to be a lifelong learner. And I think that's really important from just the things that we're learning day to day now. You know, this is new for our country, and it's one of those things that you have to see on top of the current literature.

So one of the interesting things is it's only been in the last decade that nurses were required by the state of Illinois to log continuing ed hours. And that just seems crazy to me. We have people like licensed barbers that were required to have hours long before this, but nurses weren't. And so like I said, really staying on top of the current evidence-based practices would be something that's important.

And lastly-- and this is something that I'm sure is really hard today, especially for a lot of our staff-- but it's smile and smile a lot. You may be having a bad day, but that person you're interacting with is probably having a worse day. And so I just want to encourage everybody just to be the bright spot in that patient's day.

VINCE LARA: And you are also in health care management. So what should someone in health care management expect?

TAMMY SERAPHIN: This is a fun one as I talk to potential students who want to go into health administration. And one of the key things that I talk about is expect and embrace change. If you don't like-- or, I'm sorry. If you like doing the same things every day in your job, then a career in health administration is likely not for you.

When you really think about all of the rules, and regulations, and guidelines that surround our health care systems, and then you add in the recommendations that suggest changing how physicians, and allied health professionals, and nurses practice, there's this constant motion in health care. And some of these changes are very welcome, and some will be met with strong resistance.

So definitely change and appreciating change is something that leaders would have to do. In addition to that, I would say learning to appreciate another's expertise and bringing them to the table anytime you're looking at making major changes. Leaders in health care organizations all have different backgrounds. Some are clinical, some financial, some are technology-based.

And one of the things I found in basically the last decade when I was working more in the administrative roles is that health care decisions really shouldn't be made unilaterally, because one decision can strongly impact, say, another unit or department without someone even realizing it. And two, explain the whys behind the major changes.

Staff are not always going to agree when changes are made in the organization. But if they at least understand the why, you're more likely to get buy-in and compliance with that change. And we're certainly seeing a lot of change in practices right now.

VINCE LARA: That's for sure. Speaking of one of those changes is nurses being allowed to enter the field without finishing their final semester, as I mentioned earlier. Is that something you agree with?

TAMMY SERAPHIN: You know, Vince, this is kind of a tricky one for me, because I want to support, especially those new nurses getting out there and getting that experience. But there's generally a lot of clinical time that's required during that final semester. And they're unfortunately experiencing cancellations of those clinical opportunities.


TAMMY SERAPHIN: I've been reading some could be offering simulations that could help support that last semester of learning. And certainly, I can see that. Back in the day, we used to even have an option of practicing what they called, like, RNLP, which was Registered Nurse License Pending. And I suppose we could go back to something like that on a temporary basis while nurses wait to take their national licensing exam.

But I guess what I'm kind of concerned about is the fallout of pushing new nurses out there quickly with unrealistic expectations, and here's why. Nursing school is great. We get prepared to get out there and provide great patient care. But it's really only a snapshot of what the reality is like. In nursing school, you take care of one, maybe two patients.

And what we're seeing now, nurses are taking care of five, six, sometimes seven or eight. And as I mentioned earlier, that nursing retention rate for the first couple of years isn't great. So a few of the reasons that I've read where nurses are providing for why they leave is that the workload is too heavy or it's too fast-paced.

They've had nonexistent, or poor mentorships, or poor receptor ships. And just the emotional toll that sometimes these roles take on. So if these new nurses are pushed into a role where they've not received proper orientation and have that good mentorship, they're going to be more likely to leave the profession.

And not only when someone leaves is that disruptive to operational workflows and scheduling, but it's expensive for the organization in both time and money when you have to replace employees. So can this work? Maybe. But I would certainly want to proceed with caution putting those brand new nurses into a situation like this.

VINCE LARA: Sure. Speaking of proceeding with caution, what should people know for best practices when they're going outside during this crisis?

TAMMY SERAPHIN: Yeah. So I really strongly encourage folks just to follow the CDC and public health guidelines for physical distancing. It's definitely OK to go outside. And certainly as this weather gets warmer, a little sun and fresh air can do wonders for someone's mood and you their emotional health.

And, of course, just the promotion of physical activity-- of course, not in big groups. But just going out for the walk, or a jog, or a bike ride, it encourages us to stay healthy as well. So that's really when you're outside, just avoid the big groups. But definitely get out there and enjoy the sunshine.

VINCE LARA: Yeah. And I think going back to that answer, is there anything, any behavior you've seen or heard about that you'd discourage?

TAMMY SERAPHIN: Well, I will tell you my biggest peeve right now is the use of social media to spread misinformation and create more panic. Social media is a great way to certainly reach a lot of readers, for lack of a better term. But getting folks to pay attention to only the credible sources is challenging.

And one of the things I've heard is from a local physician, he was quoted as saying something like, pay attention to the science, and avoid the stories. And I believe really just taking that, and that's a great start. And basically, just don't believe every you're reading.

VINCE LARA: My thanks to Tammy Seraphin. For more podcasts on Illinois' College Applied Health Sciences, search A Few Minutes With on iTunes, Spotify, I Heart Radio, and other places you get your podcast fix. Thanks for listening, and see you next time.

back to news